Small fiber neuropathy refers to the loss and/or degradation of small nerve fibers in the skin and eyes (and perhaps elsewhere) of approximately 40% of people with fibromyalgia and/0r chronic fatigue syndrome (ME/CFS) as well. These nerve fibers can transmit sensory and autonomic nervous system signals to the brain.

Studies indicate that the presence of SFN exacerbates the symptoms of fibromyalgia. While the role SFN plays in fibromyalgia, ME/CFS, postural orthostatic tachycardia syndrome (POTS), and now long COVID is unclear, it could help explain the pain, central nervous system sensitization, and even autonomic nervous system problems found in these diseases.

Resources

Diagnosis

• Diagnosing Small Fiber Neuropathy
• An Easy Way to Tell if You Have Small-Fiber Neuropathy? The Fibromyalgia Symptom Study (2017)
• Small Fiber Neuropathy Symptom Screening List
• Diagnosing Fibromyalgia The Small Nerve Fiber Way

Treatment

• The Case for IVIG Treatment in Chronic Fatigue Syndrome (ME/CFS), Fibromyalgia, Small Fiber Neuropathy, and POTS : IVIG#3 (2018)

Research

Fibromyalgia (FM)

• Is Fibromyalgia and Chronic Fatigue Syndrome Actually Small Fiber Polyneuropathy? (2020)
• How Nucynta – an Opioid Drug – Told Us Something About the Small Fiber Neuropathy in Fibromyalgia (2020)
• More is Not Better: Increased Small Nerve Fiber Problems in Fibromyalgia Spell Trouble (2019)
• Is the Brain Causing the Small Fiber Neuropathy in Fibromyalgia (and ME/CFS?) (2019)
• 2018 Dysautonomia International Conference I: Small Fiber Neuropathy, POTS, MCAS and Vagus Nerve Stimulation (2018)

• Small Nerves – Big, Big Problem? Drug Trial Points Finger at Autoimmunity in Fibromyalgia and ME/CFS (2017)

• More Than Skin-Deep: The Small Nerve Fiber Problems in Fibromyalgia – A Review

• Small Nerve Fiber Study Finds Different Kinds of Fibromyalgia Exist (2016)

• Optic Nerve Thinning Suggests Fibromyalgia is “Neurodegenerative” Disease (2016)
• Eye-Opening Finding: Small Fiber Neuropathy Found in Fibromyalgia Patient’s Eyes
• Fibromyalgia, Small Fiber Neuropathy and Eye-Opening Developments in Pain Research: An FM and Pain Researcher Talks
• Small Fiber Neuropathy Fibromyalgia Studies Mount But Does SFN Cause Pain in FM?
• Small Fiber Nerve Study Suggests New Era in Fibromyalgia (and Perhaps Chronic Fatigue Syndrome) Could Be At Hand
• Damaged Neuroprotective Process Spells Pain for Fibromyalgia – Suggests Small Fiber Neuropathy is Present
• Small Nerve Fiber Neuropathy Commonly Found in Fibromyalgia (and Linked to Central Sensitization) (2014)
• Are Both Small AND Large Fiber Neuropathy Present in Fibromyalgia? (2014)
• The ‘Body’ is Back in Fibromyalgia: Small Nerve Fiber Damage Suggests The Pain Begins There (2014)
• Small Fiber Neuropathy Fibromyalgia Study Raises Questions
• Small Fiber Nerve Study Suggests New Era in Fibromyalgia (and Perhaps Chronic Fatigue Syndrome) Could Be At Hand (2013)
• Hands Up! A Key to the Fatigue, Sleep, and Pain in Fibromyalgia Found? (2013)

Chronic Fatigue Syndrome (ME/CFS)

• Damaged Small Nerve Fibers May be Causing Energy Problems in Chronic Fatigue Syndrome (ME/CFS) (2021)
• Is Fibromyalgia and Chronic Fatigue Syndrome Actually Small Fiber Polyneuropathy? (2020)

Long COVID (PASC)